The role of epigenetics in kidney diseases

Epigenetics is the study of changes in gene expression that occur without changes in DNA sequence. These reversible modifications include DNA methylation, histone acetylation and RNA interference. Epigenetic changes are fundamental for the regulatory physiological processes that regulate gene activity; therefore, these changes are altered in response to environmental factors or disease states, but, in many circumstances, they are also believed to contribute to disease occurrence and progression. So far, studies of the epigenome have been scarce in nephrology. However, there is evidence that in the uremic milieu, several features such as inflammation, dyslipidaemia, hyperhomocysteinaema, oxidative stress as well as vitamin and nutritional deficiencies may affect the epigenome, and impact patient outcome. The present review describes the current knowledge on epigenetic alterations in the course of various kidney disease states. Although the science of epigenetics is still in its infancy, it seems that it may help elucidate the pathogenic mechanisms in uraemia, and allow novel treatment strategies to be developed.